Tag Archives: Washington University St. Louis

Washington University in St. Louis study: Air pollution contributes significantly to diabetes globally

1 Jul

Cheryl Katz wrote the 2012 Scientific American article, People in Poor Neighborhoods Breathe More Hazardous Particles:

Tiny particles of air pollution contain more hazardous ingredients in non-white and low-income communities than in affluent white ones, a new study shows.
The greater the concentration of Hispanics, Asians, African Americans or poor residents in an area, the more likely that potentially dangerous compounds such as vanadium, nitrates and zinc are in the mix of fine particles they breathe.
Latinos had the highest exposures to the largest number of these ingredients, while whites generally had the lowest.
The findings of the Yale University research add to evidence of a widening racial and economic gap when it comes to air pollution. Communities of color and those with low education and high poverty and unemployment face greater health risks even if their air quality meets federal health standards, according to the article published online in the scientific journal Environmental Health Perspectives.
Los Angeles, Pittsburgh, Cincinnati, St. Louis and Fresno are among the metropolitan areas with unhealthful levels of fine particles and large concentrations of poor minorities. More than 50 counties could exceed a new tighter health standard for particulates proposed by the Environmental Protection Agency.
Communities of color and those with low education and high poverty and unemployment may face greater health risks even if their air quality meets federal health standards. A pervasive air pollutant, the fine particulate matter known as PM2.5 is a mixture of emissions from diesel engines, power plants, refineries and other sources of combustion. Often called soot, the microscopic particles penetrate deep into the lungs.
The new study is the first to reveal major racial and economic differences in exposures to specific particle ingredients, some of which are linked to asthma, cardiovascular problems and cancer…. http://www.scientificamerican.com/article/people-poor-neighborhoods-breate-more-hazardous-particles/

A University of Miami Miller School of Medicine expanded upon the link between neighborhood greenness and disease.

Science Daily reported in Study links neighborhood greenness to reduction in chronic diseases:

A new study of a quarter-million Miami-Dade County Medicare beneficiaries showed that higher levels of neighborhood greenness, including trees, grass and other vegetation, were linked to a significant reduction in the rate of chronic illnesses, particularly in low-to-middle income neighborhoods. Led by researchers at the University of Miami Department of Public Health Sciences at the Miller School of Medicine, and the School of Architecture, the study showed that higher greenness was linked to significantly lower rates of diabetes, hypertension and high cholesterol, as well as fewer chronic health conditions.
The findings, published online April 6 by the American Journal of Preventive Medicine, are based on 2010 — 2011 health data reported for approximately 250,000 Miami-Dade Medicare beneficiaries over age 65, and a measure of vegetative presence based on NASA satellite imagery. The study was the first of its kind to examine block-level greenness and its relationship to health outcomes in older adults, and the first to measure the impact of greenness on specific cardio-metabolic diseases.
“This study builds on our research group’s earlier analyses showing block level impacts of mixed-use and supportive building features on adults and children,” said lead study author Scott Brown, Ph.D., research assistant professor of public health sciences. Brown was a co-principal investigator on the study with Elizabeth Plater-Zyberk, M.Arch., a Malcolm Matheson Distinguished Professor in Architecture. Plater-Zyberk, who was responsible for the rewrite of the City of Miami’s zoning code in 2010, said the study results “give impetus to public agencies and property owners to plant and maintain a verdant public landscape.”
Study findings revealed that higher levels of greenness on the blocks where the study’s Medicare recipients reside, is associated with a significantly lower chronic disease risk for the residents of high greenness blocks, including a 14 percent risk reduction for diabetes, a 13 percent reduction for hypertension and a 10 percent reduction for lipid disorders….. https://www.sciencedaily.com/releases/2016/04/160421171345.htm

A Washington University in St. Louis study reported a link between pollution and diabetes.

Science Daily reported in Air pollution contributes significantly to diabetes globally:

New research links outdoor air pollution — even at levels deemed safe — to an increased risk of diabetes globally, according to a study from Washington University School of Medicine in St. Louis and the Veterans Affairs (VA) St. Louis Health Care System.
The findings raise the possibility that reducing pollution may lead to a drop in diabetes cases in heavily polluted countries such as India and less polluted ones such as the United States.
Diabetes is one of the fastest growing diseases, affecting more than 420 million people worldwide and 30 million Americans. The main drivers of diabetes include eating an unhealthy diet, having a sedentary lifestyle, and obesity, but the new research indicates the extent to which outdoor air pollution plays a role.
“Our research shows a significant link between air pollution and diabetes globally,” said Ziyad Al-Aly, MD, the study’s senior author and an assistant professor of medicine at Washington University. “We found an increased risk, even at low levels of air pollution currently considered safe by the U.S. Environmental Protection Agency (EPA) and the World Health Organization (WHO). This is important because many industry lobbying groups argue that current levels are too stringent and should be relaxed. Evidence shows that current levels are still not sufficiently safe and need to be tightened.”
The findings are published June 29 in The Lancet Planetary Health.
While growing evidence has suggested a link between air pollution and diabetes, researchers have not attempted to quantify that burden until now. “Over the past two decades, there have been bits of research about diabetes and pollution,” Al-Aly said. “We wanted to thread together the pieces for a broader, more solid understanding…” https://www.sciencedaily.com/releases/2018/06/180630153740.htm

Citation:

Air pollution contributes significantly to diabetes globally
Even low pollution levels can pose health risk
Date: June 30, 2018
Source: Washington University in St. Louis
Summary:
New research links outdoor air pollution — even at levels deemed safe — to an increased risk of diabetes globally, according to a new study. The findings raise the possibility that reducing pollution may lead to a drop in diabetes cases in heavily polluted countries such as India and less polluted ones such as the United States.
Journal Reference:
1. Bowe B, Xie Y, Li T, Yan Y, Xian H, Al-Aly Z. The 2016 Global and National Burden of Diabetes Mellitus Attributable to Fine Particulate Matter Air Pollution. The Lancet Planetary Health, June 29, 2018

Here is the press release from Washington University:

PUBLIC RELEASE: 29-JUN-2018
Air pollution contributes significantly to diabetes globally
Even low pollution levels can pose health risk
WASHINGTON UNIVERSITY IN ST. LOUIS
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New research links outdoor air pollution — even at levels deemed safe — to an increased risk of diabetes globally, according to a study from Washington University School of Medicine in St. Louis and the Veterans Affairs (VA) St. Louis Health Care System.
The findings raise the possibility that reducing pollution may lead to a drop in diabetes cases in heavily polluted countries such as India and less polluted ones such as the United States.
Diabetes is one of the fastest growing diseases, affecting more than 420 million people worldwide and 30 million Americans. The main drivers of diabetes include eating an unhealthy diet, having a sedentary lifestyle, and obesity, but the new research indicates the extent to which outdoor air pollution plays a role.
“Our research shows a significant link between air pollution and diabetes globally,” said Ziyad Al-Aly, MD, the study’s senior author and an assistant professor of medicine at Washington University. “We found an increased risk, even at low levels of air pollution currently considered safe by the U.S. Environmental Protection Agency (EPA) and the World Health Organization (WHO). This is important because many industry lobbying groups argue that current levels are too stringent and should be relaxed. Evidence shows that current levels are still not sufficiently safe and need to be tightened.”
The findings are published June 29 in The Lancet Planetary Health.
While growing evidence has suggested a link between air pollution and diabetes, researchers have not attempted to quantify that burden until now. “Over the past two decades, there have been bits of research about diabetes and pollution,” Al-Aly said. “We wanted to thread together the pieces for a broader, more solid understanding.”
To evaluate outdoor air pollution, the researchers looked at particulate matter, airborne microscopic pieces of dust, dirt, smoke, soot and liquid droplets. Previous studies have found that such particles can enter the lungs and invade the bloodstream, contributing to major health conditions such as heart disease, stroke, cancer and kidney disease. In diabetes, pollution is thought to reduce insulin production and trigger inflammation, preventing the body from converting blood glucose into energy that the body needs to maintain health.
Overall, the researchers estimated that pollution contributed to 3.2 million new diabetes cases globally in 2016, which represents about 14 percent of all new diabetes cases globally that year. They also estimated that 8.2 million years of healthy life were lost in 2016 due to pollution-linked diabetes, representing about 14 percent of all years of healthy life lost due to diabetes from any cause. (The measure of how many years of healthy life are lost is often referred to as “disability-adjusted life years.”)
In the United States, the study attributed 150,000 new cases of diabetes per year to air pollution and 350,000 years of healthy life lost annually.
The Washington University team, in collaboration with scientists at the Veterans Affairs’ Clinical Epidemiology Center, examined the relationship between particulate matter and the risk of diabetes by first analyzing data from 1.7 million U.S. veterans who were followed for a median of 8.5 years. The veterans did not have histories of diabetes. The researchers linked that patient data with the EPA’s land-based air monitoring systems as well as space-borne satellites operated by the National Aeronautics and Space Administration (NASA). They used several statistical models and tested the validity against controls such as ambient air sodium concentrations, which have no link to diabetes, and lower limb fractures, which have no link to outdoor air pollution, as well as the risk of developing diabetes, which exhibited a strong link to air pollution. This exercise helped the researchers weed out spurious associations.
Then, they sifted through all research related to diabetes and outdoor air pollution and devised a model to evaluate diabetes risk across various pollution levels.
Finally, they analyzed data from the Global Burden of Disease study, which is conducted annually with contributions from researchers worldwide. The data helped to estimate annual cases of diabetes and healthy years of life lost due to pollution.
The researchers also found that the overall risk of pollution-related diabetes is tilted more toward lower-income countries such as India that lack the resources for environmental mitigation systems and clean-air policies. For instance, poverty-stricken countries facing a higher diabetes-pollution risk include Afghanistan, Papua New Guinea and Guyana, while richer countries such as France, Finland and Iceland experience a lower risk. The U.S. experiences a moderate risk of pollution-related diabetes.
In the U.S., the EPA’s pollution threshold is 12 micrograms per cubic meter of air, the highest level of air pollution considered safe for the public, as set by the Clean Air Act of 1990 and updated in 2012. However, using mathematical models, Al-Aly’s team established an increased diabetes risk at 2.4 micrograms per cubic meter of air. Based on VA data, among a sample of veterans exposed to pollution at a level of between 5 to 10 micrograms per cubic meter of air, about 21 percent developed diabetes. When that exposure increases to 11.9 to 13.6 micrograms per cubic meter of air, about 24 percent of the group developed diabetes. A 3 percent difference appears small, but it represents an increase of 5,000 to 6,000 new diabetes cases per 100,000 people in a given year.
In October 2017, The Lancet Commission on pollution and health published a report outlining knowledge gaps on pollution’s harmful health effects. One of its recommendations was to define and quantify the relationship between pollution and diabetes.
“The team in St. Louis is doing important research to firm up links between pollution and health conditions such as diabetes,” said commission member Philip J. Landrigan, MD, a pediatrician and epidemiologist who is the dean for global health at Mount Sinai School of Medicine in New York and chair of its Department of Preventive Medicine. “I believe their research will have a significant global impact.”
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A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Resources:

What are Key Urban Environmental Problems?
http://web.mit.edu/urbanupgrading/urbanenvironment/issues/key-UE-issues.html

Understanding Neighborhood Effects of Concentrated Poverty
https://www.huduser.gov/portal/periodicals/em/winter11/highlight2.html

Where We Live Matters for Our Health: Neighborhoods and Health

Click to access Issue%20Brief%203%20Sept%2008%20-%20Neighborhoods%20and%20Health.pdf

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